Clinical importance of myeloid-antigen expression in acute lymphoblastic leukemia of childhood

Article Abstract:

Lymphoblastic leukemia is an abnormal increase in the number of lymphoblasts, cells that will eventually become lymphocytes, a type of white blood cell. As is the case with many of the lineages leading to mature cell types, the paths towards maturity are biochemically marked by the appearance of antigens specific for particular cell types. The differentiation of lymphocytes is no exception, and lymphoblastic leukemias may be characterized by their expression of antigens which normally occur on T or B cells. Some lymphoblastic leukemias also express myeloid antigens, which by all rights should not appear on cells committed to the lymphocyte lineage. This mixed-lineage expression, sometimes called lineage infidelity, is thought by some to be an indicator of poor prognosis. The authors have evaluated the prognostic value of myeloid antigen expression in 236 consecutive cases of acute lymphoblastic leukemia in childhood. Antigens indicating B cell lineage were detected in 185 patients and T cell antigens were detected in 41; in 10 patients the lineage could not be conclusively identified. Forty-five of 185 B cell lymphoblastic leukemias also had myeloid antigen expression. Myeloid antigens could also be found in eight of the children with T cell lineage leukemic cells. Of the potential prognostic factors studied, high white blood cell count and the presence of myeloid antigens contributed most to the outcome of the case. At 40 months, the disease-free survival was 84 percent for the patients with the better prognostic indicators, that is, no myeloid antigen expression and a low white blood cell count. For patients with low white blood cell counts and myeloid antigens, survival dropped to 47 percent. Children with both myeloid antigens and high white blood cell counts had 26 percent estimated survival at 40 months. The results indicate that the presence of myeloid antigens is an important prognostic indicator among children with acute lymphoblastic leukemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Prognosis, Tumor antigens, Lymphoblastic leukemia in children, Acute lymphocytic leukemia, Childhood leukemia

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Inhibin as a marker for granulosa-cell tumors

Article Abstract:

Granulosa-cell tumors are tumors of the ovary responsible for 5-10 percent of cases of ovarian cancer. The tumor can become very large and can produce large amounts of the hormone estrogen. It is associated with problems of menstruation, infertility, and early puberty. Surgical removal is the usual treatment for granulosa-cell tumors. However, spread to neighboring organs is common and 80 percent of these patients die when the disease returns. Fortunately some tumors respond to combinations of chemotherapeutic drugs. Granulosa cells of the ovary normally secrete a hormone, inhibin. To determine whether excess inhibin release can be used as a marker for detecting granulosa-cell tumors, six women having granulosa-cell tumors were examined. Three women had surgery removing both ovaries and the uterus. The inhibin levels of two of these women who had recurrent tumors were found to be high before signs of the disease reappeared. In one patient having no evidence of the disease over an eleven year period, the inhibin level remained undetectable. High levels of inhibin in three women revealed granulosa-cell tumors; the levels decreased after the tumors were removed. Inhibin is considered to be an adequate marker for detecting granulosa-cell tumors in initial and recurrent disease presentations.

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Inhibin: from hypothesis to clinical application

Article Abstract:

The role of substances secreted by the ovaries may offer insight into the causes and treatment of infertility. The hormone inhibin is normally produced by the granulosa cells in the ovaries. It has been found that inhibin is secreted in excess in patients with granulosa-cell tumors of the ovaries. Inhibin can prevent the secretion of the follicle stimulating hormone (FSH) needed for proper ovulation in women and sperm development in men. Some studies have found that blocking the action of inhibin can increase ovulation. It has also been found that two subunits of inhibin, in combination, produce activin which activates FSH, the opposite action of inhibin alone. These two substances can stimulate activities in other parts of the body. Inhibin may also be used as a marker for another tumor, hydatidiform mole, a tumor-like abnormal pregnancy. The role of inhibin in male contraception is being investigated.

Infertility, editorial

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